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Immigrant generation and diabetes risk among Mexican Americans: the Sacramento area Latino study on aging
Aimee Afable-Munsuz1, Elizabeth Rose Mayeda, Eliseo J Pérez-Stable
1At the time the analysis was conducted, Aimee Afable-Munsuz was a research fellow with the Division of General Internal Medicine, Department of Medicine, University of California, San Francisco. Elizabeth Rose Mayeda and Mary N. Haan are with the Department of Epidemiology and Biostatistics, University of California, San Francisco. Eliseo J. Pérez-Stable is with the Medical Effectiveness Research Center for Diverse Populations, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco.
Objectives:
We examined whether acculturation and immigrant generation, a marker for assimilation, are associated with diabetes risk in an aging Mexican-origin population.
Methods:
We analyzed data on 1789 adults aged 60 to 101 years from the Sacramento Area Latino Study on Aging. We ascertained type 2 diabetes on the basis of diabetic medication use, self-report of physician diagnosis, or a fasting glucose of 126 milligrams/deciliter or greater. Logistic regression modeled prevalent diabetes.
Results:
Adjusting for age and gender, we observed significant but divergent associations between immigrant generation, acculturation, and diabetes risk. Relative to first-generation adults, second-generation adults had an odds ratio (OR) of 1.8 (95% confidence interval [CI] = 1.4, 2.4) and third-generation adults had an OR of 2.1 (95% CI = 1.4, 3.1) of having diabetes. Greater US acculturation, however, was associated with a slightly decreased diabetes rate. In the full model adjusting for socioeconomic and lifestyle factors, the association between generation (but not acculturation) and diabetes remained significant.
Conclusions:
Our study lends support to the previously contested notion that assimilation is associated with an increased diabetes risk in Mexican immigrants. Researchers should examine the presence of a causal link between assimilation and health more closely.
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